“Future growth of private direct medicine may not look like the past,” concludes Eischen. “As a more diverse array of stakeholders need to come together to balance how to better integrate private health and wellness services with the traditional diagnosis and treatment services of plan-reimbursed healthcare.”

By Michael Tetreault, Editor

Dr. Pamila Brar

AUGUST 10, 2017 In a statement released to Concierge Medicine Today by Dr. Pamila Brar, current President of the American Academy of Private Physicians (AAPP) stated “Due to evolving marketplace conditions in the private medicine conference space, our AAPP board of directors voted to suspend operations in 2017 and to evaluate AAPP’s ongoing usefulness and value proposition for 2018 and beyond.”

Formerly known as the Society of Innovative Medical Practice Design (SIMPD) for many years, the AAPP’s presence, conferences and representatives served a limited, but engaged physician audience in unique ways. They focused on five key areas which included: legal compliance for doctors; innovative learning tracks at national meetings; physician networking; legislative and lobbying initiatives and staying up to date on new and emerging technologies. Although AAPP is suspending operations and evaluating the organization’s future, other physician organizations involved in private direct medicine seem to be experiencing strong membership growth.

Throughout an entire career however, physicians are faced with recurring questions related to medical associations: Which associations should I join? Which should I retain membership in? How do you decide which associations to pass on altogether? Simply type in the words ‘medical association’ and 29,200,000 plus results are found on Google alone.

Throughout an entire career however, physicians are faced with recurring questions related to medical associations: Which associations should I join? Which should I retain membership in? How do you decide which associations to pass on altogether? Simply type in the words ‘medical association’ and 29,200,000 plus results are found on Google alone. When nearly sixty percent of physicians in 2017 cite that they took Less than 5 Business Education courses …, certainly associations and physician groups must adapt to the needs of its base. Concierge Medicine and its variants operating in the U.S. today work because so many people have made it work. Concierge Medicine and the like, work because a few visioneering physicians broke every standard delivery tradition they knew to embrace the mission of the Golden Rule: Treat others the way you would want to be treated. ~Editor

A recent story in Forbes noted that ‘Nonprofits can be a great way for a community to mobilize around a cause, make an impact and deliver services to those in need.’

Following that, in November 2016, Becker’s Hospital Review cited relevant physician association challenges and wrote that nationally, 57.4 percent of physicians are part of a state medical society; 73.8 percent of physicians are members of a national specialty society; 31 percent of physicians are a current Member of the American Medical Association; and finally, 10.1. percent of physicians are a Member of the American Osteopathic Association.[1]

However, even with so many options today and increasing annual dues, the membership of the American College of Physicians nearly doubled between 1995 and 2009, reaching 130,000 members. The American College of Surgeons, with 77,000 members, has also seen tremendous growth in the past three decades. In June, the American Academy of Family Physicians announced that its membership had reached an all-time high of 100,300. [2]

Most doctors join medical societies and associations for what they can get, not for what they can contribute. Maybe this paradigm should be reversed, like many antiquated processes in today’s healthcare marketplace. Often the decision to join is influenced by a medical association’s position on hot-button political issues, such as healthcare reform. Many medical associations’ benefits are similar: access to discounts on medical devices; discounts on malpractice insurance; CME credit courses and webinars; hands-on help in choosing an EMR/EHR; participation at national or regional events and conferences; and advocacy for issues affecting members. It’s the last benefit where the difference in associations is generally revealed.

In the early 1950s, approximately 75% of US physicians were AMA members. That percentage has steadily decreased over the years. In June 2011, at the annual meeting of its policy-making body, the House of Delegates, the AMA announced that it had lost another 12,000 members last year.

Optimism regarding Concierge Medicine, the delivery of Direct Primary Care and other private medicine business structures remains high among both consumers, executive healthcare professionals and physicians alike. In fact, a recent career satisfaction poll of the private physician community [e.g. Concierge Medicine, Direct Primary Care, Micro Clinic, etc.], reveals that nearly 90% of physicians in this niche community of healthcare professionals are highly satisfied with their career move into these entrepreneurial healthcare delivery business models There are models in which patients pay either an annual membership or monthly fee to be a part of the doctor’s practice.

“I think that this is an exciting time for private direct medicine,” says Jim Eischen, Esq., attorney with McGlinchey Stafford LLP. “With all sorts of stakeholders exploring private medicine solutions: this is no longer primarily a solo or small physician-owned medical practice space. Larger systems and providers, and even non-provider enterprises, are all exploring how to accomplish improved health outcomes with private consumer investment and expanded communication/connection. But there are challenges with how to integrate with the tax code, and with plan requirements.”

“There are differences …and regardless of what you hear, you must choose the one that works for your career. Both have great patient and physician benefits.” INFOGRAPHIC … (Source: Concierge Medicine Today, 2007-2017)

However, the trend lines in 2017 related to Direct Primary Care (DPC) for example, reveal that the independent, solo physician is regrouping and possibly consolidating in its service line offering after two DPC groups announced their closures earlier this year [2017]. When asked, ‘Will DPC Stay Small? Grow Big? Optimism? What’s in store for Direct Primary Care?’, more than 13% of physicians are hopeful HSA and FSA integration inside DPC will occur to help patients pay for their monthly memberships. Additionally, nearly 18% of respondents to the online poll stated ‘I hope DPC Doctors Can Work/Partner With More Businesses to Save HC Costs …’ and nine percent noted ‘I hope to see the creation of DPC networks for Employer Use (sim. to MCOs) come into the market.’ Self-insured employers are beginning to show interest in the ways in which these models can improve health outcomes and contain costs according to several industry insiders.

“There is no better strategy than a major issue campaign to increase the number of people in an association or professional society,” said Catherine Sykes, Publisher of Concierge Medicine Today,The Direct Primary Care Journal and Concierge Medicine Canada. “If properly managed, associations will use a new issue campaign as an opportunity to expand their sources of information and the number of people involved in that aspect of the work. Most organizations focus on building a membership network and often underestimate the need to build the value of their own organizations while struggling to win on public issues. As in the case of the corn farmer from Iowa, the thought is ‘if you build it, they will come.’”

When nearly sixty percent of physicians in 2017 cite that they took Less than 5 Business Education courses …, certainly associations and physician groups must adapt to the needs of its base. However, Concierge Medicine and its variants operating in the U.S. today work because so many people have made it work. Concierge Medicine and the like, work because a few visioneering physicians broke every standard delivery tradition they knew to embrace the mission of the Golden Rule: Treat others the way you would want to be treated.

“Since AAPP was originally designed to help support self-employed physicians seeking to convert to a private direct model, I think demand for live conferences focused on self-employed physicians limits the draw,” says Eischen. “More web-based education, along with live conferences structured to integrate the entire range of stakeholders, is the probable downstream solution for moving private direct medicine conferences/education forward.”

“Comprehensive Pharmacogenomics for example, is a powerful healthcare innovation,” adds Sykes. “Concierge Medicine is seen by many as providing the ideal delivery model for the future of precision medicine. Used under the guidance and application of a Concierge Physician, these innovative tests can have a predictive effect on patient treatment outcomes. Whole genome sequencing, genetic testing and comprehensive profiling with more than 50 well-established pharmacogenomic genes in a single, cost-effective test can provide medically actionable and clinically relevant data, allowing Concierge Physicians, to make a more informed and thoughtful treatment recommendation for the health and well-being of each patient. Concierge Medicine Today strongly supports use of this innovative testing.”

“Future growth of private direct medicine may not look like the past,” concludes Eischen. “As a more diverse array of stakeholders need to come together to balance how to better integrate private health and wellness services with the traditional diagnosis and treatment services of plan-reimbursed healthcare.”

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